Do the first few steps out of bed each morning cause intense, sharp pain in your foot and heel? Plantar fasciitis might be the cause.
Morning foot and heel pain is a distinctive feature of the presence of plantar fasciitis. Many sufferers wonder, why does my heel hurt in the morning?
The reason is because while we are sleeping, our feet and ankles naturally shift into a plantar flexed position (toes pointed downward) and this shortens the calf, Achilles tendon, and plantar fascia overnight.
So, when you take that first step in the morning, there is a sudden stretch of the soft tissues and the pain is immediate. It does seem to diminish as you continue to walk, however.
This is the short answer as to why your feet and heels hurt worse in the morning. Let's dig a little deeper into the mechanics of your foot and why morning foot pain is so debilitating.
Dr. Angela Walk
The Plantar Fasciitis Doc
Specializing in Foot & Gait Mechanics
Why Does My Heel Hurt In The Morning?
After a long period of inactivity while you sleep or when you sit for prolonged periods, the plantar fascia ligament and other soft tissues begin to shorten and tighten up.
So, when you awake in the morning and put your feet down to the ground to take your first step, you must place your heel in contact with the ground to take a step.
This rapid change in tendon and fascia length causes an immediate sharp, unrelenting pain response with the symptoms lessening as walking continues.
Experiencing heel/foot pain in the morning is a telltale sign on plantar fasciitis. It's one of the 3 signs that you may the condition.
Now that you know what may be causing your heel pain, let's look at other features of plantar fasciitis.
What Is Plantar Fasciitis?
Plantar Fasciitis is the most common cause of foot and heel pain. It involves a break down, or degeneration of the collagen fibers in the plantar fascia, a thick, fibrous band that runs from your heel to your forefoot.
Symptoms include pain at the inside portion of the heel that is worse after prolonged periods of rest and with the first steps in the morning.
It is more appropriately called plantar fasciosis since inflammation plays a lesser or no role based on recent studies.
3 Signs You Have Plantar Fasciitis
To help you better determine if your heel pain is being caused by plantar fasciitis, here are 3 signs that will help you confirm the diagnosis.
1. Pinpoint tenderness on the inside aspect of your heel bone
The plantar fascia begins at your heel bone and fans out into your forefoot and attaches at the metatarsals. Take your finger and apply pressure to the inside portion of your heel bone. If this creates pain, this is the first sign you may have plantar fasciitis.
2. Pain with the first steps out of bed in the morning or after sitting for a prolonged period.
We have already discussed this step previously in this article. If you have heel pain with the first steps in the morning, this is the most distinctive feature of plantar fasciitis.
Also, if you have pain in the foot or heel with walking after longer periods of rest such as a long car ride or sitting at your workstation, that is another sign that you may have plantar fasciitis.
3. Pain in the arch with extension of the big toe (pulling the big toe toward the knee)
The third sign that you may have plantar fasciitis is pain with extension of the big toe. Pull your big toe up into extension. If this causes pain in your arch and heel, this is another positive test for plantar fasciitis.
What Is The Main Cause Of Plantar Fasciitis?
Ill-fitting footwear is the #1 cause of most foot and heel conditions including plantar fasciitis. The most common footwear mistake people make is wearing footwear that narrows or tapers at the toe.
When we cram our feet and toes into narrow toe boxes, our feet can not function normally and overtime begin to weaken. The intrinsic muscles of our feet begin to atrophy. This sets us up for conditions such as plantar fasciitis.
The solution is to transition into natural, functional footwear that is widest at the toe and has no heel elevation. I have compiled a complete list of Approved Shoes For Plantar Fasciitis here.
These are the design features required for healthy footwear:
A wide toe box to encourage natural toe splay and spreading of the toes
A flexible sole to encourage enhanced foot strength
A completely flat shoe from heel to toe to encourage natural arch support
A thin sole that is not heavily cushioned
How To Prevent Heel Pain In The Morning
The best way to prevent this debilitating morning event is to perform flexibility stretches and massage techniques before your feet hit the floor.
Let's look at a few simple exercises that will help.
Morning Plantar Fasciitis Exercises
Gratefully, there are pain relief techniques that will ensure your morning experience is not so unpleasant.
In order to loosens the soft tissues in your foot and lower leg, I recommend the following series of stretches and exercises before you take the first steps in the morning.
While you are still in the bed, try this active stretch of the hamstring and calf muscle group.
1. Hamstring and Calf Muscle Group Active Stretch
Straighten you leg completely, then pull your toes toward your knee. Contracting your shin muscles and quadriceps muscle (the muscles on the front of your upper and lower leg).
When you contract these 2 muscles, that naturally releases and stretches the calf and hamstring muscles. Hold each stretch/contraction for 2 seconds and perform 10 repetitions.
This type of stretching is called Active Isolated Stretching (AIS) and is more effective than static stretching (holding a stretch for 20-30 seconds).
2. Plantar Fascia Dynamic Stretch
The second stretch that I recommend is performing a towel stretch. It is stretching the same muscles as in step one, yet this stretch gets a little deeper into the muscles of the leg and targets the plantar fascia (the bottom of the foot).
Stretch the plantar fascia by using a belt or towel to gently pull the ball of your foot into a flexed position. Hold each stretch for only 2 seconds, and complete 10 repetitions.
3. Self Massage Of The Foot & Calf Muscle
The third mobility technique is self massage of the bottom of the foot and calf muscles with your thumbs or using a fascial release tool.
Warming up the soft tissues and bringing in good circulation before you take your first steps in the morning, is another great relief technique.
One of the soft tissue mobilization techniques I recommend is using a fascial release tool to eliminate restrictions in your fascia.
The fascial release tool has a beveled edge that is specifically designed to help you locate adhesions. You will sense a vibration when you scrape across an adhesion
An alternative would be to use a table spoon. It would be the closest object with a similar surface and weight. Find one that has a thicker surface and handle.
Using a massage tool , handle of a table spoon, or your thumbs, find areas that feel impinged, tight or tender.
Apply a light layer of emollient balm or essential oils over the treatment area.
Using the edge of the tool or your thumbs, apply unidirectional strokes using moderate pressure.
Continue for 15-20 seconds in a single area before moving onto another area.
Repeat 2-3 times per week on each of these soft tissues: Gastrocnemius, Soleus, Achilles Tendon & Plantar Fascia
If you need further direction on removing adhesions in the soft tissues with plantar fasciitis, find a complete guide here.
Can I Treat Plantar Fasciitis At Home?
If you have this debilitating condition, here are my top 3 recommendations.
Download my free guide. This is the first step on your PF recovery journey. I show you the exact steps to resolve plantar fasciitis at home.
Take a look at my approved footwear guide. Dr. Angela's Recommended Shoe List and make sure you are not sabotaging your recovery with wearing the wrong shoes.
Because there is a so much misinformation out there about plantar fasciitis, I spend most of my time educating people on what NOT to do.
Most rehabilitation efforts fail because they are relying on cortisone shots, night splints, orthotics, ineffective stretching, thick, cushiony shoes, and rolling on a frozen water bottle.
These methods are either ineffective or just short-term band-aids, and do not provide long-term correction.
In my (6) step free guide, I offer solutions through addressing multiple factors. Improving footwear, identifying areas of weakness in the foot and ankle, and restoring proper foot function.
If having heel pain in the morning is preventing you from enjoying your day, I hope implementing these flexibility techniques will change that.
Dealing with the pain of plantar fasciitis can be life changing--but it doesn’t have to be a life sentence.
By arming yourself with knowledge and taking charge of your healing, you can get back to the activities you love and feel like yourself again.
If you have additional questions about heel pain and plantar fasciitis, don’t hesitate to reach out. I'm here to help get you back on your feet--literally.
Best of Health,
I've written extensively on the topic of Plantar Fasciitis. Take a look at these other related blog posts:
Hi, I'm Dr. Angela Walk... I have been involved in the health and wellness industry for over 25 years as a natural physician. I specialize in foot and gait mechanics and I have written extensively for health publications.
I am keenly aware of trends and new developments in natural health and I embrace an active lifestyle combining diet, exercise and healthy choices.
My goal is to inform my readers of natural options available to them in hopes of improving their health and quality of life.